DEMOLITION APPLICATION GUIDE - City of Darebin

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Demolition Application Guide (Cont).Municipal Building SurveyorCity of DarebinPO Box 91Preston VIC 3072Tel: 8470 8899Fax: 9261 4833Email: building@darebin.vic.gov.auOWNER/OWNERS AGENT DECLARATION FORMDear Sir,RE: DEMOLITION / REMOVAL OF BUILDING/S LOCATED AT……………………………………………………I declare that I am the owner or agent appointed by the owner intending to carry outdemolition / removal works at the above property.I fully understand my obligations under the Building Act 1993, Building Regulations 2006,Ministers Guidelines, News Bulletins and Practice Notes issued by the BuildingCommission.I am also aware of the requirement for this application to be referred to all relevantreporting authorities associated with this property and that NO WORKS ARE TOCOMMENCE until the issue of a building permit for the demolition/ removal of thebuilding/s and the Asset protection Permit is gained.Signed: …………………………………….Name:………………………………………………………………….Address for Correspondence: ……………………………………………..Date:…………………………………….Document Master List Document No. 40Obj. Ref. A191439 Revision No. 11Last Printed 1 July 2010Page 2 of 7
Demolition Application Guide (Cont).PROFESSIONAL DEMOLISHERS.PLEASE INSERT A COPY OF YOUR CURRENT CERTIFICATE OF REGISTRATION(DEMOLITION) OR REGISTRATION CARD AS ISSUED BY THE STATE BUILDINGPRACTITIONERS BOARD OF VICTORIA AND ALSO INSERT A COPY OF INDEMNITYINSURANCE DETAILS IN THIS SPACE.PRIVATE OWNER DEMOLISHERS.(WHO ARE EXEMPT FROM THE STATE REGISTRATION REQUIREMENTS).ORPLEASE INSERT A CURRENT COPY OF YOUR PUBLIC LIABILITY INSURANCE TOTHE MINIMUM VALUE OF FIVE MILLION AUSTRALIAN DOLLARS IN THIS SPACEINSTEAD.PLEASE INSERT RELEVANT DOCUMENTS BETWEEN THESEPAGES.PLEASE INCLUDE A CURRENT COPY OF THE ‘CERTIFICATE OF TITLE’APPLICABLE TO THE LAND WHERE THE BUILDING IS TO BEDEMOLISHED/REMOVED IN THIS SPACE.PLEASE INSERT TITLE BETWEEN THESE PAGES.Document Master List Document No. 40Obj. Ref. A191439 Revision No. 11Last Printed 1 July 2010Page 3 of 7
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DEMOLITION APPLICATION GUIDE - City of Darebin

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